Human albumin solution utilization patterns prior and during COVID-19 pandemic in United Arab Emirates: Time to develop and implement national guidelines on prescription and utilization

Addressing Drug Shortages at Mediclinic Parkview Hospital: A ‎Five-Year Study of ‎Challenges, Impact, and Strategies

Background Drug shortages have become a significant challenge globally, affecting healthcare delivery and patient outcomes. This study aimed to assess drug shortages' prevalence, causes, and impact at a tertiary care hospital in Dubai, the United Arab Emirates (UAE), providing actionable insights for future mitigation strategies. Methods A retrospective descriptive study was conducted at Mediclinic Parkview (MPAR) Hospital, part of Mediclinic Middle East (MCME), UAE. Data were collected from January 2019 to December 2023. Reported drug shortages were analyzed to assess their frequency, duration, causes, and management, with a focus on identifying trends and underlying factors. Results Drug shortages peaked at 995 in 2020, particularly during the COVID-19 pandemic. The median time spent managing shortages reached 19.5 days per shortage in Q3 2020. Oral forms accounted for the highest frequency (n = 2231), representing 61% of all shortages, followed by topical forms (n = 414, 11%) and injection forms (n = 386, 10%). Most affected drugs were in the infectious disease (n = 547, 15%), cardiovascular (n = 387, 11%), and respiratory (n = 330, 9%) categories. Drug shortages were driven by regulatory issues and manufacturing delays (39%), unknown reasons (29%), and supply chain disruptions exacerbated by the pandemic (10%). A monopoly environment worsened the situation and limited sourcing flexibility, with 66% of shortages linked to zero supply competitors. Tirzepatide (n = 20) and oseltamivir (n = 18) were the drugs most frequently reported to be unavailable over the 60-month study interval. Regarding management efforts, 80% of the time was spent gathering information and communicating with the different stakeholders. The hospital's response included contacting prescribers for alternatives and increased reliance on internal procurement and inter-pharmacy coordination. These shortages caused significant operational strain, with increased workloads and higher costs. Conclusion The study highlighted the need for adopting proactive measures, improved strategies, enhanced communication, and better preparedness to address future drug shortages. Key actions involved investing in technology, strengthening supplier relationships, and advocating for policy reforms to mitigate risks and ensure continuity of care.

Exploring the Economic Aspects of Hospitals: A Comprehensive Examination of Relevant Factors

Financial limitations in the hospital industry have the potential to exacerbate healthcare disparities, impede investments in cutting-edge medical treatments, as well as impair patient outcomes. The interdependent connection between a hospital economy and the general well-being of the community highlights the necessity of careful financial oversight and inventive healthcare policies. Effective collaboration among policymakers, healthcare administrators, and stakeholders is imperative in the development of sustainable economic models that give equal weight to fiscal prudence and optimal patient outcomes. This article aims to underscore the pivotal importance of strategic fund allocation guided by hospital administrators, accentuating several key initiatives capable of revolutionizing healthcare delivery and elevating the institution's stature within the medical community. The other important aspects discussed here are fund allocation in hospitals, the boom of online consultations, and emphasis on the use of sustainable and cost-effective modalities of energy.

Development and validation mental training model: Mental Toughness Training Circle (MTTC)

Background: A systematic and comprehensive mental training program to enhance athletes' mental toughness is critical. The aim of this study was to develop and validate a set of athletes' systematic mental training programs. Methods: A mental toughness training program was developed, and the validity and reliability were tested on experts, practitioners, and athletes. Training program was analyzed using content validity index (I-CVI and S-CVI) and modified Kappa ( k *). Furthermore, estimation of reliability of mental training model was analyzed by internal consistency approach with Cronbach's alpha and inter-rater reliability (IRR) approach by using intraclass correlation coefficients (ICC). Result: A mental toughness training circle (MTTC) was successfully developed with four sections: general preparatory, specific preparatory, precompetitive, and competitive with 11 mental skills (positive thinking, mental log, goal-setting, breathing, relaxation, concentration, self-talk, mental imagery, leadership, managing anxiety, and managing emotions). Validation assessment found that the I-CVI and S-CVI values (S-CVI/Ave and S-CVI/UA) were 1.00, each suggesting excellent content validity. The modified Kappa value ( k*) was 1 and categorized as excellent. The results of the reliability test using Cronbach's alpha showed that a value was in the range 0.723 to 0.835 with an overall value of 0.803. The results of the ICC analysis also confirmed that MTTC had a very high reliability coefficient value of 0.803. In addition, there was no significant difference from respondents' assessment as proved by obtaining value of F=0.754 with a p=0.644 (>0.05). This suggested that respondents tend to be consistent in assessing MTTC as a mental training set which was categorized as relevant (scale 3) or very relevant (scale 4). Conclusion: MTTC which has four sections with 11 mental skills is a set of mental training programs that have high quality. Further studies to validate this program in a bigger sample size is required.